Pregnancy and neonatal outcomes in patients treated for glioma before or during pregnancy: a single-institution retrospective series.

BACKGROUND: Glioma diagnosed during pregnancy and pregnancy following glioma treatment present complex management challenges. Safety of glioma treatment during pregnancy is not well established. The ability to counsel patients on timing of conception after treatment remains limited. The aim of this study was to describe our institution's experience with pregnancy during and/or after treatment for glioma. METHODS: In this single-institution study, we retrospectively identified patients diagnosed with glioma during or prior to pregnancy and described treatment courses and maternal and neonatal outcomes. RESULTS: Twenty-one female patients were included. Glioma diagnoses included 12 high-grade tumors and 9 low-grade tumors. Cohort A consisted of 8 patients who presented with glioma during pregnancy, of which, 7 underwent glioma treatment during pregnancy. All pregnancies in cohort A were without significant maternal complications and resulted in delivery of a healthy neonate. Cohort B consisted of 13 patients who experienced pregnancy after a prior diagnosis of glioma, totaling 18 pregnancies that resulted in delivery of a neonate. Antepartum course was complicated by seizure in 3/18 pregnancies. Functionally inconsequential anatomic abnormalities in childhood offspring of cohort B occurred in 5/18 pregnancies. Anatomic abnormalities occurred in 4/13 (31%) of temozolomide exposed offspring and 1/5 (20%) of temozolomide unexposed offspring. CONCLUSIONS: In this retrospective series, diagnosis of glioma before or during pregnancy was associated with generally favorable maternal, fetal and childhood outcomes. We observed higher-than-expected rate of anatomic abnormalities in the post-diagnosis cohort, though none carried meaningful functional consequences. These findings add to the limited literature exploring pregnancy outcomes in patients with glioma.